This Mentored Patient-Oriented Career Development Award (K23), in response to PA-09-043, is designed to provide the candidate, Dr. Patricia van den Berg, with the training and experience necessary to establish herself as an independent patient-oriented researcher of adolescent obesity and unhealthy weight control attitudes and behaviors and their risk factors and outcomes. The prevalence of obesity among adolescents is high and increasing, and its public health effects are well-known. This is especially the case with Hispanic adolescents, who have a higher prevalence of obesity and potentially greater susceptibility to the diabetes-related outcomes of obesity. Unhealthy weight control attitudes and behaviors, such as body dissatisfaction and extreme dieting, are also highly prevalent among Hispanic and non-Hispanic white adolescent girls, and some researchers have posited that they may constitute risk factors for obesity among adolescents. For instance, it is possible that among adolescents, restrictive dieting leads to overeating and binge eating, resulting in greater weight gain over time. Research in this area is needed to develop improved obesity and disordered eating prevention interventions. Candidate: Dr. van den Berg is an Assistant Professor and BIRCWH Scholar in the Department of Obstetrics & Gynecology at the University of Texas Medical Branch. Dr. van den Berg's long-term career goal is to contribute to the prevention of obesity and disordered eating among adolescents. A coordinated program of coursework, mentoring by successful patient-oriented researchers, and research experience is proposed to address the candidate's identified need for training in school-based research, qualitative research, research with Hispanic participants, longitudinal data analysis and the design and evaluation of effective obesity prevention programs. Mentoring will be provided by Dr. Tom Baranowski of the Children's Nutrition Research Center at Baylor College of Medicine and Dr. Abbey Berenson and Dr. Susan Weller of UTMB. Environment: UTMB provides an ideal environment for the training and research proposed, supported by outstanding programs to assist new investigators in transitioning to independence. Research: The proposed research focuses on the relationships among unhealthy weight control behaviors and attitudes, obesity, obesity-related behaviors such as nutrition and physical activity, and common risk factors for these variables. Because of their high prevalence of obesity and/or unhealthy weight control attitudes and behaviors, Hispanic and non-Hispanic white adolescent girls are targeted. Three studies are proposed: Aim 1 is a qualitative interview study of overweight and lean, Hispanic and non-Hispanic white adolescent girls designed to uncover novel potential risk factors for obesity and unhealthy weight control attitudes and behaviors; Aim 2 is a 1-year longitudinal school-based survey study of 400 Hispanic and non-Hispanic white adolescent girls to test the longitudinal association between potential risk factors and obesity and unhealthy weight control attitudes and behaviors; and Aim 3 is the development and pilot testing of a combined obesity and disordered eating prevention program that targets the risk factors identified in Aims 1 and 2. PUBLIC HEALTH RELEVANCE: Because both obesity and the use of unhealthy weight control attitudes and behaviors, such as excessive dieting and poor body image, are high among adolescents, there is a need to train new investigators in areas related to both of these problems. Further, studies in this area with adolescent girls from diverse backgrounds are limited. Advancing knowledge in this area will lead to improved obesity and disordered eating prevention interventions.